NPIMap

Organization Active NPI

Cooper Medical Group PC

Doing business as Cooper Medical Group

  • Family Medicine Physician
  • Evansville, IN
National Provider Identifier
1881996130
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
02002249A Issued in IN
Legal business name
COOPER MEDICAL GROUP PC
Doing business as
Cooper Medical Group
Practice address
1401 S Green River Rd
Evansville, IN 47715-5657
Phone
(812) 476-4161
Fax
(812) 476-4178
NPI assigned
Nov 18, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Keith Eugene Cooper, D.O.
Title
Owner / Physician
Phone
(812) 476-4161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 02002249A IN Primary

Addresses

Primary practice location

1401 S Green River Rd
Evansville, IN 47715-5657

Mailing address

1401 S Green River Rd
Evansville, IN 47715-5657
Phone (812) 476-4161

Other names 1

  • COOPER MEDICAL GROUP Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1290038400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1881996130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477155657",
            "telephone_number": "812-476-4161",
            "fax_number": "812-476-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 S GREEN RIVER RD",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477155657",
            "telephone_number": "812-476-4161",
            "fax_number": "812-476-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOPER MEDICAL GROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-18",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN",
        "authorized_official_telephone_number": "812-476-4161",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02002249A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COOPER MEDICAL GROUP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.